Mental Health & Counseling

What If They Don’t Want Help?

June 24, 2022

So here’s the question of the week. Or the century. How do you help someone who doesn’t want help? 

The short answer is you don’t. The second short answer is you pray for them. 

The long answer is a little more complex, much more work, and probably uncomfortable in the end. 

First let’s consider the very valid question of what help looks like for this person. Help may be different than what we’ve scripted or what we think should happen. We all have opinions and ideas of how we think a person should respond, act, and react. We have a way or a solution that we think is best for them. And many times our way, or the way we perceive help, may actually be the best for them. But sometimes God’s way is different, and ultimate healing or the route to it may actually be different then we think. Certainly the timeline is often different than we expect. This is something to contemplate and consider seriously and prayerfully when looking at any situation. 

Let’s explore here what it means to support a person with a need by addressing and speaking to their external and internal structures. What does this mean from a practical standpoint? An internal structure relates to a person’s emotional, mental, or spiritual make-up. It’s what makes them tick. External structures are the things outside the mind that directly connect them to their environment. This can be anything from their physical body, family members, and money, to the car they drive and their employment.

External structures can sometimes be barriers a person confronts. If he is not wanting help, dig deeper and try to understand the possible barriers that stand between him and a solution. The barrier may be financial—I can’t afford medication or counseling. It may be logistics—I have no vehicle. It may be physical—My knees are shot. In medicine I can discharge someone from the hospital but if they are unable to pick up their medication or have no car to drive to a follow-up appointment, I can soon expect to see them back in the emergency room. 


Consider someone who does not see themselves as being the problem or needing help but who behaves in an emotionally destructive or abusive manner. In this case placing boundaries can speak to their internal structures. Remember that a boundary is not a dictate placed on the person; rather it is a promise you make yourself. As you cannot force a verbally or emotionally abusive adult to stop their behaviors, you must place limits and boundaries on your own responses, reactions, and reciprocal behaviors. One boundary may be that when they begin to berate, threaten, or verbally tear you down, you will quietly leave the room. That person may then begin to realize that their behaviors are no longer eliciting the responses they once did. This ultimately may bring them to the insight that they need help. 

Here’s a real-life example: A husband may verbally berate and abuse his wife. His wife may feel she needs to just put up with it, thinking this is a part of submission. In fact, it is not. Her pseudo-submission only serves to enable destructive behavior that fosters resentment, the death knell to any relationship. In typical situations the man doesn’t see himself as needing help so what can the woman do in this situation? She can choose a time when he is calm and better inclined to conversation and quietly and calmly tell him that she will no longer listen when he goes off on her. She can outline her boundary clearly. The next time he begins to berate and batter her she can simply say, I won’t listen to this, and excuse herself from the room. This is not avoidance or the silent treatment; rather it’s a promise you make yourself in response to negative and unhealthy behavior. 


If a person refuses help, don’t avoid them or allow yourself to be intimidated. They still need you and deep down they likely realize they need help. Educate yourself on their issue, whatever that is, if you have an inkling, but take care to not label them or build a case at this point. This will only serve to drive wedges and make them hide, shrink back, or repress further. Embarrassment is another common internal structure—perhaps the person just needs to hear that they are not alone, we are all broken, and God still cares. 


What about an individual diagnosed or suspected of having a mental disorder, say bipolar to use one example. In the case when the person refuses to take his medication, he then may experience major depressive lows, including suicide threats. In order to help, we may simply have to take advantage of his threats and call the medics. He may end up in a psych unit against his will but this, in the big picture, will be helpful. Or maybe bargaining will help: you refuse medication? Ok, how about weekly counseling sessions then? 

Perhaps you will need to take advantage of a lucid moment when you can appeal to common sense: Do you like things the way they are? Are you happy with how your life is going right now? Don’t you become weary with those highs and lows? Does it seem constructive when you lose your temper and break things? How does it make you feel to not have a job? Do you really appreciate the fact that you’re isolating yourself and have no meaning in life? Wouldn’t you enjoy having better relationships? 

Speaking of medication. Sometimes a person just needs to hear that taking medication has nothing to do with his worth and is not an indication of how weak or strong he is. Sometimes it helps to explain that he doesn’t have a heart condition or a liver condition; rather he has a brain condition. Would he take meds for high blood pressure? A urinary tract infection? Crohn’s disease? Yes, probably, strong guy or not. Well, this is a similar situation.  


Recently someone shared a quote with me that is impressive in depth: 

“The strength of the bridge (love) between our hearts needs to be sufficient to support the weight that I am intending to carry across to him.”

Kevin Ehst

If someone we love needs help but does not realize it yet or has chosen to ignore it or outright rejected the obvious, we get nowhere through force or coercion. We are much better served to let patience have its perfect work and build a bridge through love and compassion. As that bridge is strengthened, trust becomes an inevitable part of that structure and often opens doors to hearing the hard thing. This is another way, and probably the most effective, of addressing internal structures. 

In the end the choice is theirs. Ultimately it is not up to us to do anyone else’s hard work, make choices for them, or take responsibility for their healing. Our task is to love, to support, and to be available. 


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